I'm Not Lovin' It

So, San Francisco last year prohibited the inclusion of free toys in kids' meals that fail to meet nutritional standards. The so-called "Happy Meal Ban" goes into effect on December 1. So what are San Francisco McDonald's restaurants doing? Charging ten cents for the toy.

Update: Burger King, too.

Laptop Connected to Internet Can Damage Sperm

Bad news for road warriors who are also aspiring dads: a recent article in Fertility and Sterility indicates that sperm is severely damaged by exposure to electromagnetic forces associated with wireless communication. Four hours of exposure to laptop WiFi left 25 percent of sperm dead, as opposed to only 14 percent kept at the same temperature away from WiFi; and 9 per cent of sperm showed DNA damage--more than three times as much damage as comparison samples.

HIV (Lack of) Awareness

This CDC report says that of 1.2 million Americans with HIV, 240,000 don't know they're infected. Of every 100 people with HIV, 80 know they have it, 62 are linked to HIV care, 41 stay in care, 36 get antiretroviral therapy, and 28 have their viral loads well controlled. We're used to saying, glibly, that in the US HIV used to be a death sentence, but now it's only a chronic illness. But the fact is that we need to do a lot better on testing and treatment. 16,000 per year are still dying of AIDS--not a large number, as causes of death go (AIDS has been outside the top 15 causes of death since 1997); but AIDS is still a leading cause of death in certain sub-populations, e.g., among younger women and African-Americans. We can do better.

2011: Tenth-hottest Year Ever

The World Meteorological Organization is reporting that 2011 is looking to be the 10th warmest year on record, and the warmest-ever La Nina year. (La Nina years are typically cooler than the years before and after them.) The decade from 2002-2011 is tied with 2001-10 for having the highest average temperatures on record. 13 of the hottest 15 years on record have occurred within the last 15 years. Arctic sea ice extent was at its second smallest level ever, the smallest having been recorded in 2007; and sea-ice volume hit a record low.

Paralyzed Man Seeks Right to Be Killed

Tony Nicklinson, a British man who is paralyzed from the neck down as a result of a stroke, is going to court in order to challenge the law against murder. He is asking that he be permitted to have a physician euthanize him at his request. Last year's guidelines from the Director of Public Prosecutions on prosecution for assisted suicide made it clear that, while some sorts of assistance in patient suicide would not be prosecuted, "[i]t is murder or manslaughter for a person to do an act that ends the life of another, even if he or she does so on the basis that he or she is simply complying with the wishes of the other person." Mr. Nicklinson's case against the Ministry of Justice seems to be an effort to carve out a medical exception to the manslaughter/murder law. I don't expect it will succeed.

New Jersey Nurses Sue to Avoid Abortion Care

The University of Medicine & Dentistry of New Jersey recently and abruptly changed its conscientious objection policy to require nurses to provide care to hospital patients before and after they undergo abortion procedures. Previously, the University had permitted nurses to avoid caring for abortion patients at all, if they objected morally to abortion; but the new policy requires them to deliver pre- and post-operative care. Nurses are still free to decline to participate in, or to be present in the room during, the abortion procedure itself. A dozen nurses have sued to stop the implementation of the policy, and in November a judge granted a restraining order barring the hospital's training of nurses in pre- and post-operative abortion care until after its December 5 hearing on the case. Conscientious objection laws for healthcare providers are problematic, particularly if they reduce access to necessary medical services; but here there seems to be no question of the availability of the procedure. It seems to me that being required to take care of a pregnant mother just prior to her abortion, and then again just after it, is seriously offensive to a nurse who's morally opposed to abortion. If the nurses who feel strongly about this issue are a small minority of available nursing staff (which they seem to be), then I think the University ought to return to its previous, more sensitive, conscientious objection policy.

Obese Child Seized by State

Ohio officials have taken an eight-year-old child away from his mother and placed him into foster care because they believe his mother has been unable to help the child control his weight. (The boy weighs 200 pounds, while normal weight for an 8-year-old is 60.) State authorities had been working with the mother to reduce the boy's weight for 20 months. The boy has been diagnosed with sleep apnea. In this interview, Art Caplan offers several reasons why the state's move was wrong: the removal from his mother will cause emotional turmoil; there's no proof that foster care will help control the boy's weight; the foster-care system is already overwhelmed and there are too many morbidly obese kids to make this a viable policy; the boy will eventually return home, where bad habits and social conditions may not have changed during his absence; and, finally, while the boy's weight places him at high risk for future disease, his obesity does not put him in the kind of imminent danger normally needed to justify removal from the home. On this last point, bioethicist Norm Fost disagrees; he's quoted in the first article linked above as saying that the boy's sleep apnea could be placing him in imminent danger.

Removing the child from home can't be the right approach. It may be true that his mother is incapable of taking basic steps to control his weight. But even on that assumption, his obesity is likely to have social, emotional and physical origins that even very fine foster care will be ill-equipped to address. Perhaps he'll lose weight when he's away from his home--or perhaps the emotional turmoil will make it harder for him to lose weight. In any case, he'll eventually return home, and what will happen then? Meantime, his mother is surely learning the wrong lesson about the benevolence of state interventions on her son's behalf.

Heart Patients: Quantity Please, Not Quality!

MSNBC Health is reporting on the findings of this paper from the European Heart Journal. Faced with various heart-disease-related symptoms (shortness of breath, fatigue, weakness, swelling of the legs and feet), three-quarters of elderly Swiss heart patients surveyed said they wouldn't prefer a one-year symptom-free life to two years with symptoms--and the severity of their symptoms was not a good predictor of who'd pick quality over quantity. Most wanted CPR if they coded--and, stunningly, researchers found that patients' preferences for resuscitation varied from what was actually entered on their charts about one-third of the time.

The finding that most of these subjects actually preferred two years of symptom-burdened life to one year symptom-free is, I'm guessing, likely to be counterintuitive to a number of bioethicists--particularly to the young, healthy ones who haven't yet had to make any concessions to their failing bodies.